Assistive technology has been one of key words in the field of special education. It will also be new trend of special educational development. In the article, the authors firstly introduced the definition of assistive technology device and assistive technology service and discussed the relationship between assistive technology and educational technology, and special educational changes in technology and idea because of the use of assistive technology, at last, some suggestions to enhance the use of assistive technology were put forward.

Objective To observe the changes in acid-base balance and the contents of electrolytes in patients during liver transplantation to explore the relationship between such changes and ASA grading, and to look for an optimal anesthetic intervention. Methods Arterial pH, PaO_2, PaCO_2, HCO~-_3, BE, K~+, Ca~ 2+ , Na~+, and glucose were monitored in 89 patients undergoing liver transplantation at four specific periods: before anesthesia (T_0), after skin incision (T1), 10 minutes before reperfusion (T_2), and 10 minutes after reperfusion (T_3). Changes in blood acid-base and electrolyte parameters of the patients with different ASA status were compared. Result The pH and BE in ASA V patients was significantly lower at T_0, T_1, T_2 and T_3, and HCO~-_3 was lower in ASA V at T_3. The PaCO_2 in ASA V patients was significantly higher at T_0, T_1 and T_2. The Na~+ content in ASA V patients was significant higher at T_2 and T_3. At T_0 and T_1, the glucose level in ASA Ⅳ and Ⅴ were significant higher than in ASAⅢ. Significant differences in pH, PaCO_2, HCO~-_3, BE and glucose level were observed at different stages of the surgical procedure. The pH, BE and HCO~-_3 were significantly lowered at T_2 and T_3. Mean glucose and HR levels were gradually increased from T_1 to T_3. Conclusion Patients with advanced ASA grades are more prone to acid-base and electrolyte disturbances during reperfusion of the liver transplant. High ASA grades contitute an increased risk for cardiovascular collapse after reperfusion, calling for proper treatment.

BACKGROUND: Anterior cervical discectomy and fusion (ACDF) is a gold standard to treat degenerative cervical syndrome. However, with the increasing application and follow-up data of ACDF, its adverse effects have been shown. In the past 20 years,artificial cervical disc replacement has been widely used in clinic, and the therapeutic effect is favorable.OBJECTIVE: To assess the effect of cervical disc replacement versus ACDF for cervical radiculopathy or myelopathy.METHODS: A computer-based online search of Medline (1966/2009-06), Embase (1966/2009-06), CBM (2009-06) and CNKI(2009-06), as well as Cochrane Back Group, and Cochrane library were performed to collect randomized controlled trials of cervical disc replacement versus ACDF. Data were evaluated by RevMan4.2.2 for Meta analysis.RESULTS AND CONCLUSION: A total of 15 studies were included. Meta-analysis indicates that no differences were found in the mean operation time, mean blood loss, mean hospital stay, satisfaction rate, and complication between two groups; the reoperation rate of the disc replacement group was lower than ACDF group in two years postoperation; disc replacement group was more efficient in improving cervical function indexes than ACDF group, and the postoperative SF-36 scores were significantly more than ACDF group. Moreover, postoperative motion range of affected segment was significantly greater in the disc replacement group than the ACDF, and the motion rage of adjacent segment was significantly increased in patients underwent ACDF compared with disc replacement treatment. However, there may be bias, more randomized controlled trials are required.

A questionnaire survey on the awareness and knowledge about stroke was conducted in 392 residents of Fangzhuang community.The results showed residents in Fangzhuang had high awareness rate about stroke,the rates of knowing early symptoms of stroke were from 57.91％ to 79.08％.83.16％ (326) of residents knew to dial 120 or 999 at emergency.The community doctors were thought as the main resource of gaining the knowledge of stroke (78.32％ ).The results indicate that Fangzhuang community health service center plays an important role in health education and guidance for emergent management of stroke in the community.

Metallic cancellous screw is one of the fixation devices widely used for bone fractures. It has always been reported that many cases of internal fixation failed just because of screw loosening or pullout. The stability of fixation is associated with the pullout strength of screws. The pullout strength strongly depends on the geometrical design of the screw thread, the material and the insertion technique of the screw, and the bone mineral density of the insertion site of the screw.

Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis complex and is mainly manifested as pulmonary tuberculosis. Mycobacterium tuberculosis is characterized by high pathogenicity and drug resistance due to its high viability and lethality, and multidrug-resistant tuberculosis caused by it has become a global public health problem. Early and effective treatment is essential to prevent the emergence of drug-resistant strains. Commonly employed methods for the screening and diagnosis of TB include: clinical signs, imaging examinations (chest X-ray, computed tomography), sputum culture (L-J medium, BACTEC liquid culture system), and immunological tests (lipoarabinomannan antigen test, tuberculin skin test, interferon-gamma release test). In recent years, emerging molecular diagnostic methods such as GeneXpert MTB/RIF assay, loop-mediated isothermal amplification (LAMP), linear probe assay, and whole-genome sequencing have been used to diagnose and characterize TB. These methods not only identify Mycobacterium tuberculosis but also detect mutation sites associated with resistance to first-line anti-tuberculosis drugs (isoniazid, rifampicin, etc.), providing new possibilities for the diagnosis of drug-resistant Mycobacterium tuberculosis. In this paper, the advantages and disadvantages of some commonly used detection methods for tuberculosis are first reviewed, aiming at assisting clinicians to diagnose and treat the disease in a timely manner. Secondly, this paper explores the prospects of the latest high-throughput detection methods for drug-resistant Mycobacterium tuberculosis.

OBJECTIVE:To observe therapeutic efficacy and safety of lansoprazole triple therapy in the treatment of Helicobacter pylori (Hp) associated gastric ulcer.METHODS:A total of 80 patients with Hp associated gastric ulcer were randomly divided into control group (40 cases) and combination group (40 cases).Control group was given Lansoprazole capsules 30 mg once in the morning or before bedtime,for 6 weeks.Combination group was given Lansoprazole capsules (same usage and dosage as control group)+Clarithromycin tablets 0.5 g,twice a day+Amoxicillin dispersible tablets 1 g,twice a day,for consecutive 1 week,and then given Lansoprazole capsules 30 mg once in the morning or before bedtime,for 5 weeks.Patients with amoxicillin allergy were switched to Metronidazole tablets 0.4 g,twice a day.Hp eradication rate of 2 groups were observed;recrudescence rate of Hp negative patients and the recurrence of effective patients were observed after 6,12 months of treatment.The leve1s of Th1 cytokines (IFN-γ,IL-2,IL-12) and Th2 cytokines (IL-4,IL-6,IL-10) were observed before and after treatment,and the occurrence of ADR was recorded.RESULTS:There was no statistical significance in total response rate of ulcer healing,Hp eradication rate or the incidence of ADR between 2 groups (P＞0.05).After 6 months of treatment,there was no statistical significance in recurrence rate between 2 groups (P＞0.05).The recurrence rate of combination group after 12 months of treatment and recrudescence rate of combination group after 6,12 months of treatment were significantly lower than those of control group,with statistical significance (P＜0.05).Before treatment,there was no statistical significance in Th1 type cytokines and Th2 cytokines between 2 groups (P＞0.05).After 1 week and 6,12 months of treatment,the levels of INF-γ,IL-2,IL-12 and IL-6 in 2 groups were significantly lower than before;the levels of INF-γ,IL-2 and IL-12 in combination group were significantly lower than control group after 12 months of treatment.After 1 week and 6,12 months of treatment,the levels of IL-4 and IL-10 in 2 groups were significantly higher than before;those indexes of combination group were significantly higher than those of control group after 12 months of treatment,with statistical significance (P＜0.05);but there was no statistical significance in the level of IL-6 between 2 groups (P＞0.05).CONCLUSIONS:Lansoprazole triple therapy shows significant therapeutic efficacy for Hp associated gastric ulcer,improve cytokines level and reduces recurrence rate and recrudescence rate without increasing the incidence of ADR.

Objective: To optimize and establish the best hydrolysis method of diethyl ester 4-amino-N5-formyl-N8,N10-dideazatetrahydrofolate through the optimization of simple compound of diethyl N-(4-aminobenzoyl)-L-glutamate.Methods: To increase the low yield of hydrolysis reaction of diethyl ester 4-amino-N5-formyl-N8,N10-dideazatetrahydrofolate due to the by-products and difficult purification, we studied the effect of NaOH and KOH, two kinds of alkalis, three concentrations between 0.175-1 mol/L and five types of reaction time involved in 20, 30, 60, 120 and 180 min on the common side chain diethyl N-(4-aminobenzoyl)-L-glutamate.A high performance liquid chromatography was established for measuring the target product and the by-products in reaction liquid in different reaction conditions.Finally, on the basis of the best hydrolysis method of diethyl ester 4-amino-N5-formyl-N8,N10-dideazatetrahydrofolate, we completed the optimization of the hydrolysis reaction conditions of diethyl ester 4-amino-N5-formyl-N8,N10-dideazatetrahydrofolate.Results: We developed the best reaction condition for the hydrolysis of diethyl ester 4-amino-N5-formyl-N8,N10-dideazatetrahydrofolate, which could be carried out easily and efficiently.The results indicated that treated with the optimized condition of 0.3 mol/L KOH in 60 min at the room temperature, diethyl ester 4-amino-N5-formyl-N8,N10-dideazatetrahydrofolate was converted into its diacid derivative in 95.6 % yield, which turned to be a better reaction condition compared with the previous reaction condition.The structures of those compounds were identified to be correct by 1H nuclear magnetic resonance(1H NMR), 13C nuclear magnetic resonance(13C NMR) and electrospray ionization time of flight mass spectrometry (ESI-MS).The purity of the diacid derivative of the compound was determined to be 96% by high performance liquid chromatography(HPLC).The new hydrolysis reaction condition could not only avoid the formation of single ester hydrolysis product and amide bond hydrolysis product, but also improve the yield of the hydrolysis reaction.Conclusion: We have developed an efficient reaction for the hydrolysis of diethyl ester 4-amino-N5-formyl-N8,N10-dideazatetrahydro.Since the final step of the synthesis of classical folic acid antagonists is always the catalyzed hydrolysis of the side chain glutamate, the reaction also has great significance for anti-folic acid anti-tumor inhibitors synthesis.

Objective: To investigate the relationship between heart rate variability (HRV), blood pressure variability (BPV) and autonomic nerve function, blood vessel damage in patients with essential hypertension (EH) via synchronous monitoring. Methods: A total of 275 EH patients admitted to our hospital from 2011-04 to 2014-01 were enrolled. The vascular function was assessed by carotid-femoral pulse wave velocity (PWV). Based on PWV, the patients were divided into 2 groups: Normal PWV group (PWV<9m/s),n=185 and High PWV group (PWV≥9m/s),n=90. Synchronic 24h dynamic electrocardiogram (Holter) and 24h ambulatory blood pressure monitoring (ABPM) were performed in all patients. t-test, chi-square test, person liner correlation study and multi stepwise regression analysis were conducted to explore the relationship between HRV, PBV and PWV. Results: HRV and BPV in High PWV group had been changed unusually. Compared with Normal PWV group, High PWV group showed decreased standard deviation of the average of all normal-to-normal intervals in all 5-minute intervals (SDANN) (159.66±66.50) ms vs (194.36±119.29) ms and increased 24 h systolic blood pressure standard deviation (24h SSD) (14.40±3.65) mmHg vs (12.98±3.46) mmHg, all P<0.01; increased new index of night/day HR ratio (0.90±0.08) vs (0.87±0.06), P<0.01 and it had liner correlation to PWV (r=0.169, P=0.005). Multi stepwise liner regression analysis indicated that 24hSSD and HRV at low frequency (LF) portion had obvious and independent correlation to PWV (standard β value=0.352 and 0.212 respectively). Conclusion: ① EP patients were with decreased HRV (SDANN), increased BPV (24h SSD) and the higher incidence of arteriosclerosis; 24h SSD and HRV at LF portion were the most 2 important risk factors affecting PWV. ②Autonomic nerve dysfunction, vagus nerve over-excitatory were the independent risk factors for promoting the occurrence and development of arteriosclerosis in EH patients. ③Night/day HR ratio as a sensitive index for examining autonomic nerve function was independently related to hypertensive vessel damage. Synchronic monitoring of HRV and BPV is helpful to identify blood vessel damage in EH patients.

Objective:To investigate the effects of IRF 3 shRNA adenovirus on dynamic changes of early cytokines in LPS-stimulated primary Kupffer cells ( KCs ).Methods: Rat KCs were isolated and purified by means of in situ perfusion.After being infected with adenovirus carrying IRF 3 shRNA for 48 h, KCs were stimulated with LPS.Cell culture supernatants were collected respectively at 0,2,4 and 6 h after LPS stimulation as well as cells at 6 h.Supernatant cytokine secretion levels were detected by enzyme-linked immunosorbent assay ( ELISA).Intracellular gene expressions were tested by RT-PCR and Westeron blot.Results:IRF3 mRNA and protein were induced by LPS ,but suppressed by IRF 3 shRNA adenovirus in LPS-stimulated or non-stimulated KCs.IFN-βsecretions rose in the very early stage ( at 2 h) ,reached the peak at 4 h,and began to reduce but still remained high levels at 6 h after LPS stimulation in KCs.Interference adenovirus pretreatment suppressed IFN-βsecretions ( especially the secretion peak ) at each time point after LPS stimulation.IFN-βsecretions reached normal levels at 6 h after the stimulation in adenovirus-pretreated cells;TNF-αse-cretions rapidly increased in the very early stage and reached the peak at 2 h,then began to decrease gradually ,but remained high levels at 6 h after LPS stimulation in KCs.Interference adenovirus pretreatment inhibited LPS-induced TNF-αsecretions, especially the secretion peak;IL-1βsecretions did not increase untill 4 h, but reached a higher level at 6 h after LPS stimulation.Interference adenovirus suppressed IL-1βsecretions in the early stage of LPS stimulation;IL-10 secretions began to rise in the very early stage ,and gradually increased over time after LPS stimulation in KCs.Pretreatment of adenovirus with IRF 3 shRNA promoted upregulations of IL-10 secretions at each time point of the early of LPS stimulation.Conclusion:IRF3 gene expression can be silenced by IRF 3 shRNA ad-enovirus.IRF3 can promote its downstream signaling molecule IFN-βand pro-inflammatory cytokines including TNF-αand IL-1β,and block anti-inflammation cytokine IL-10 secretions in LPS-stimulated primary KCs.Therefore,IRF3 may play a central role in immune inflammatory injury of liver tissues.